Footer Template with Initials Text

Footer Template with Initials text : (version 2.09)

Important: You will need to apply the footer below to your consent form document. This footer is required as the IRB will be watermarking all pages of your consent document.

For many years the Pitt IRB has mandated that subjects initial each page of a consent form, sign the final page, and receive a copy of the consent document. The federal regulations require that subjects sign the consent form and receive a copy of the document but do not require that each page be initialed. As part of an on-going evaluation of IRB policies and procedures, the Pitt IRB has rescinded the initialing requirement as of 6. February 2009.

We understand that research sponsors or organizations occasionally require that subjects initial each consent form page; under those circumstances, the initial footer may remain. This should be explained in the IRB protocol.

of 1 Participant’s Initials ______

University Of Approval Date: «Approval IRB #: «IRBNo» Pittsburgh Date» Institutional Review Expiration Date: Board «Renewal Date»